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SA N r10 A Q U IN Environmental Health Department <br /> —COUNTY— ���� <br /> 9. Employee: Initial if you agree to abide by the following:6— <br /> I understand that I may not have more than one full-time equivalent cottage food employee, not including a <br /> family member or household member of the cottage food operator,working within the registered or permitted <br /> area of a private home where the cottage food operator resides and where cottage food products are prepared <br /> or packaged for direct, indirect,or direct and indirect sale to consumers. <br /> 10. Delivery Limitation: Initial if you agree to abide by the following: <br /> I understand that I may accept orders and payments via the internet, mail or phone. However,all"Class A"and <br /> "Class B"CFO products must be delivered directly(in person)to the customer.The CFO products may not be <br /> delivered via the United States Postal Service, UPS,FedEx, or using any other indirect delivery method as <br /> deliveries are regulated by,and subject to, CDPH registration and state and federal requirements. <br /> 11. Owner's Statement: <br /> I, 61(r6 US �aVA OJ ,agree to grant access to the local health department to <br /> conduct an inspection of my cotta a food operation(mark one) <br /> Class A": In the event of a consumer E] "Class B": For regular annual facility <br /> complaint or reported food-borne illness inspections and in the event of a consumer <br /> (/-7 II , ,, I complaint or food-borne <br /> I, v1 lG` S V(ti��-r ,agree to notify the San Joaquin County <br /> Environmental He Ith Department gkior to modifying my food list, type of operation, and/or method of <br /> selling, distributing, or otherwise providing my CFO products to the consumer or retailers, regardless of <br /> whether the product is sold, consigned,or given away. �� r <br /> " tU '7 v,V <br /> wnerY Signature V Print Name Date <br /> i <br /> 50t5 <br /> EHD 1677 6129117 CFO REG/PERMnTING FORM <br />